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GI anatomy all Flashcards

1
Q

where does the stomach lie

A

epigastric region

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2
Q

where does the jejunum lie

A

the umbilical and left lumbar region

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3
Q

where does the ileum lie

A

the hypogastrium and pelvic region

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4
Q

where does the caecum and appendix lie

A

right iliac

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5
Q

where does the ascending colon lei

A

right inguinal> right lumbar

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6
Q

where does the transverse colon lie

A

the umbilical

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7
Q

where does the descending colon lie

A

left lumbar> left inguinal

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8
Q

where does the sigmoid colon lie

A

the left iliac

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9
Q

where does the liver lie

A

epigastric

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10
Q

where does the pancreas lie

A

umbilical. tail enters the left hypochondrium

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11
Q

where does the spleen lie

A

left hypochondrium

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12
Q

what are the nine regions of the abdomen

A

right hypochondrium, epigastric, left hypochondrium

right lumbar, umbilical, left lumbar

right iliac, hypogastrium, left iliac

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13
Q

role external oblique

A

compress abdominal viscera, flex trunk, contralateral rotation

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14
Q

order of abdominal muscles

A

external oblique> internal oblique> TA

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15
Q

role of internal oblique

A

ipsilateral rotation, bilateral contraction

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16
Q

role of transversus abdominis

A

compress abdominal contents

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17
Q

innervation of the anterolateral abdominal muscles

A

anterior rami t7-t12

IO and TA also have L1

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18
Q

what are the anterolateral muscles

A

TA, EO, IO

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19
Q

what are the vertical muscles

A

rectus abdomonis

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20
Q

role rectus abdomonis

A

stabilises pelvis during walking, depresses ribs

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21
Q

what forms the rectus sheath- anterior and posterior walls

A

formed by aponeuroses of the three flat muscles, encloses the RA.

anterior wall- EO, half of IO
posterior wall- half of IO, TA

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22
Q

what happens halfway between umbilicus and pubic symphysis

A

the aponeuroses move to the anterior wall of rectus sheath. no posterior wall- RA touches transversalis fascia

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23
Q

where is parietal vs visceral peritoneum derived from

A

parietal- somatic. pain is localised

visceral- splanchnic. pain is poorly localised

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24
Q

what are the retroperitoneal organs

A

SAD PUCKER
suprarenal glands
aorta
duodenum (apart from proximal 1/3)

panceras
ureters
colon
kidneys
oesophagus
rectum
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25
Q

what is a mesentry

A

double fold of peritoneum

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26
Q

which mesentry gives the liver and spleen

A

ventral- liver

dorsal- spleen

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27
Q

what is the falciform ligament

A

connects anterior liver to ventral wall of abdomen. remnant of ventral mesentry

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28
Q

what is the lesser omentum

A

connection between liver and stomach. originates from ventral mesentry

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29
Q

what is the gastro colic ligament

A

part of greater omentum that connects the greater curvature of the stomach to the transverse colon. It forms part of the anterior wall of the lesser sac. dorsal mesentry remnant

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30
Q

what is the gastrosplenic ligament

A

connects stomach and spleen. remnant of dorsal mesentry

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31
Q

what is the splenorenal ligament

A

connects spleen to posterior abdominal wall. remnant of dorsal mesentry

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32
Q

describe the structure of the greater sac

A

divided by transverse colon into supra colic and infra colic regions. supracolic- stomach, liver spleen
infracolic- small intestine, ascending and descending colon

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33
Q

what connects the greater and lesser sac

A

foramen of windsor

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34
Q

where is the hepatic renal recess

A

subhepatic space that separates the liver from the right kidney

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35
Q

where is the sub-diaphragmatic recesss

A

a potential space that lies between the right lobe of the liver and the inferior surface of the diaphragm.

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36
Q

where is the recto uterine pouch

A

pouch between uterus and rectum. pouch of Douglas- lowest point in abdo cavity

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37
Q

where is the rectovescical pouch

A

between rectum and bladder

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38
Q

where is the parabolic gutters, and what are their role

A

peritoneal recesses on the posterior abdominal wall lying alongside the ascending and descending colon, allow a passage for infectious fluids from different compartments of the abdomen.

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39
Q

what is the inguinal ligament formed from

A

thickened lower border of aponeurosis of EO muscle.

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40
Q

role inguinal ligament

A

support soft tissues in the groin area and anchor the abdomen and pelvis. connect oblique muscles to the pelvis

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41
Q

opening and exit to inguinal canal

A

opening- deep inguinal ring

exit- superficial inguninal ring

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42
Q

how is the inguinal canal formed, and how can this cause hernias

A

it is the pathway that the testes are pulled down from the abdomen by the gubernaculum through. if processes vaginalis doesn’t degenerate then you can get an indirect inguinal hernia (hydrocele)

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43
Q

boundaries of inguinal canal

A

Anterior wall – aponeurosis of the external oblique, reinforced by the internal oblique muscle laterally.

Posterior wall – transversalis fascia.

Roof – transversalis fascia, internal oblique, and transversus abdominis.

Floor – inguinal ligament (a ‘rolled up’ portion of the external oblique aponeurosis), thickened medially by the lacunar ligament.

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44
Q

what is an indirect inguinal hernia

A

peritoneal sac enters through deep inguinal ring

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45
Q

what is a direct inguinal hernia

A

where the peritoneal sac enters the inguinal canal though the posterior wall of the inguinal canal.

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46
Q

what causes an indirect inguinal hernia

A
  • failure of the processus vaginalis to regress.
  • peritoneal sac and its contents may traverse the entire inguinal canal, emerge through the superficial inguinal ring, and reach the scrotum.
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47
Q

what causes direct inguinal hernia

A
  • weakening in the abdominal musculature.
  • peritoneal sac bulges into the inguinal canal via the posterior wall medial to the epigastric vessels and can enter the superficial inguinal ring.
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48
Q

compare indirect and direct inguinal hernias in relation to the inferior epigastric vessels

A

indirect- lateral

direct- medial

49
Q

borders of the hesselbachs triangle

A

Medial – lateral border of the rectus abdominis muscle.
Lateral – inferior epigastric vessels.
Inferior – inguinal ligament.

50
Q

significance of hesselbachs triangle

A

potential weakness in abdo wall, direct herniation through

51
Q

femoral canal boundaries

A

Medial border – lacunar ligament.
Lateral border – femoral vein.
Anterior border – inguinal ligament.
Posterior border – pectineal ligament, superior ramus of the pubic bone, and the pectineus muscle

52
Q

how do inguinal hernias present

A

groin pain, bulge in inguinal canal area. if incarcerated there will be painful redness.

53
Q

how do femoral hernias present

A

small lump in groin

54
Q

when do femoral hernias occur

A

Femoral hernia occur when abdominal viscera or omentum passes through the femoral ring and into the potential space of the femoral canal.

55
Q

umbilical hernia presentation

A

hernia at site of umbilicus, infant

56
Q

para-umbilical hernia

A

acquired adult, through line alba region of umbilicus.

57
Q

compare omphalocele vs gastroschisis

A

omphalocele- abdominal contents covered in peritoneum still, associated with other problems so higher mortality. through umbillical ring

gastroschisis- abdominal contents not covered in peritoneum, no other problems associated, paraumbilical

58
Q

common locations for incisional hernias

A

midline, paramedium, gridiron, Pfannenstiel

59
Q

different parts of stomach

A

going down: fundus, cardia (at superior opening), body, pylorus

60
Q

sphincters stomach

A

Inferior Oesophageal Sphincter- allows food to pass from cardiac orifice to stomach, involuntary.

Pyloric Sphincter- exit of chyme/food from stomach.

61
Q

arteries stomach

A

greater curvature- short gastric and R/L gastro-omental

lesser curvature- L/R gastric

pylorus- gastroduodenal

fundus and upper bodu- splenic artery(short and posterior gastric)

62
Q

nerves stomach

A

PS- anterior and posterior vagus trunk

S- T6-T9 spinal cord sements, passes to the coeliac plexus via the greater splanchnic nerve.

63
Q

nerves stomach

A

PS- anterior and posterior vagus trunk

S- T6-T9 spinal cord sements, passes to the coeliac plexus via the greater splanchnic nerve.

64
Q

4 parts of duodenum

A

superior, descending, horizontal, ascending

65
Q

blood supply duodenum

A

Superior (anterior, posterior) and inferior pancreaticoduodenal arteries

66
Q

innervation duodenum

A

Celiac plexus, vagus nerve

67
Q

describe superior part of duodenum

A
  • intraperitoneal
  • connects to liver via hepatoduodenal ligament
  • ends at superior duodenal flexure
68
Q

describe descending part of duodenum

A
  • retroperitoneal
  • ampulla of vater empties here
  • ends at inferior duodenal flexure
69
Q

describe horizontal duodenum

A

runs from right to left ventrally from the abdominal aorta and inferior vena cava.§

70
Q

describe ascending duodenum

A

joins the intraperitoneally lying jejunum at the duodenojejunal flexure.

71
Q

describe ascending duodenum

A

joins the intraperitoneally lying jejunum at the duodenojejunal flexure.

72
Q

what are the two liver surfaces

A

diaphragmatic- anterior.

visceral- posterioinferior. covered with peritoneum

73
Q

what are the four liver ligaments

A

falciform
coronary
triangular (R/L)-
lesser omentum

74
Q

role falciform ligament

A
  • connects anterior liver to abdominal wall
75
Q

role triangular ligaments

A
  • formed from union of coronary ligament’s anterior and posterior layers at apex of liver
76
Q

role coronary ligaments

A
  • attaches superior liver to diaphragm
77
Q

role lesser omentum

A
  • attaches liver to lesser curve of stomach and duodenum. formed of hepatoduodenal ligament and hepatogastric ligament.
78
Q

what are the three hepatic recesses

A

subphrenic (between diaphragm and anterior liver)

sub hepatic (under liver and above transverse colon)

morisons pouch (between visceral surface of liver and right kidney)

79
Q

name fibrous layer covering liver

A

glissons capsule

80
Q

lobes of liver

A

left and right, caudate at back top middle, quadrate at back bottom middle

81
Q

where is the porta hepatic

A

between caudate and quadrate lobes. transmits neuromuscular bar hepatic veins

82
Q

branches of celiac trunk

A

left gastric, splenic, common hepatic

83
Q

branches of splenic artery

A

left gastroepiploic, short gastric, pancreatic brahcnes

84
Q

branches common hepatic artery

A

proper hepatic and gastroduodenal

proper hepatic then gives rise to right gastric, R/L hepatic and cystic.

gasproduodenal then gives rise to right gastroepiploic and superior pancreatoduodenal

85
Q

branches proper hepatic artery

A

right gastric

86
Q

blood supply small intestines at L1

A

SMA

87
Q

blood supply terminal ileum and caecum

A

ileocolic artery

88
Q

blood supply jejunum and ileum

A

jejunal and ilieal arteries

89
Q

blood supply ascending colon

A

right colic artery

90
Q

blood supply transverse colon

A

middle colic

91
Q

blood supply descending colon

A

left colic

92
Q

blood supply sigmoid colon

A

sigmoidal

93
Q

describe the inferior pancreatiduodenal artery

A

first branch of SMA. anastomoses with pancreatoduodenal artery to supply pancreas and duodenum

94
Q

where does IMA arise

A

L3

95
Q

3 branches IMA

A

left colic, sigmoid, superior rectal

96
Q

structure small intestine

A

duodenum> jejunum> ileum

97
Q

where does the jejunum begin

A

duodenojejunal flexure

98
Q

where does the ileum end

A

ileocaecal junction

99
Q

compare jejunum and ileum

A
  • jejunum has thicker intestinal wall
  • jejunum has longer vasa recta
  • jejunum has less arcade
  • jejunum is pink, ileum is red
100
Q

blood supply duodenum

A

gastroduodenal (proximal) and inferior pancreatoduodenal (distal). shows change from foregut to midgut

101
Q

blood supply jejunum and ileum

A

SMA. arcades form vasa recta

102
Q

5 parts of pancreas

A

head, uncinate process, neck, body, tail

103
Q

describe biliary tree

A

cystic duct from gall bladder joins common hepatic duct, forming common bile duct. pancreatic duct joins to form ampulla of vater

104
Q

what are the portosystemic anastomoses

A

oesophagus- Left gastric veins (portal system) -> lower branches of oesophageal veins (systemic veins)

Umbilicus
Paraumbilical veins (portal) -> epigastric veins (systemic)

Upper part of anal canal
Superior rectal veins (portal) -> inferior and middle rectal veins (systemic)

105
Q

function of portosystemic anastomoses

A

Provide alternative routes of venous blood circulation when there is a blockage in the liver or portal vein.
Ensure that venous blood from the gastrointestinal tract still reaches the heart through the inferior vena cava without going through the liver.

106
Q

3 clinical signs of splenomegaly

A

ascites, splenomegaly, varices

107
Q

biliary colic

A

CCK released, gallbladder contracts. gall stone pushed against neck of gallbladder, causing temporary obstruction and pain

108
Q

acute cholecystitis

A

gall stone impacts in cystic duct. inflammation. murphys sign is positive.

109
Q

acute cholangitis

A

infection of biliary tree, causes charcots triad- pain, inflammation, jaundice

110
Q

Murphy’s sign

A

place hand on abdomen, breathe in. gall bladder hits hand causing pain

111
Q

charcots triad

A

pain, inflammation, jaundice

112
Q

acute pancreatitis

A

stone in common bile after pancreatic duct joins. obstruction and blockage to bile and enzymes in pancreas. cause autodigestion.

113
Q

what are different appendix locations

A

pelvic, subcecal, retroileal, retrocecal, ectopic, and preileal

114
Q

what is raised ALT specific to

A

hepatocyte damage (HALT)

115
Q

what is raised all phos/ALP linked to

A

biliary tree damage

116
Q

what is raised amylase linked to

A

pancreatic problems

117
Q

compare chrons and UC

A

chrons has granuloma, fistula and perianal disease. UC has mucosal inflammation, continuous inflammation and no perianal disease

118
Q

where are parietal cells located

A

body

119
Q

where are G cells located

A

pyloric antrum

gi missing (10 decks)

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